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I read an interesting article in a publication called Helio this week, which reports on a study into whether patient handwashing (as opposed to focusing on staff handwashing) can cut C. difficile rates in hospitals. The study found that education on patient hand hygiene significantly reduced the incidence of infection and noted that despite extensive evidence proving that hand hygiene is important in preventing infection, hospitalised patients are often not provided with the opportunity to clean their hands, due to mobility and cognitive obstacles as well as lack of education.
The investigators aimed to improve patient hand hygiene through staff education and patient assistance, to determine if it would reduce the rate of C. difficile infection (CDI). They conducted baseline surveys to assess patient hand hygiene, before giving staff an educational presentation on the importance of patient hand hygiene for preventing infection, which included specific times they should encourage and assist patients with hand hygiene practice.
Staff then provided education and assistance to newly admitted patients, and researchers conducted additional surveys after implementation of this intervention. During the first phase of the study involving just four medical-surgical nursing units, patient hand hygiene education increased significantly after the intervention.
Overall, 97 follow-up surveys showed the proportion of those who received hand hygiene education increased from 34% to 64%, the opportunities provided for hand hygiene increased from 60% to 86%, and the average number of times hand hygiene was performed daily increased from 2.7 to 3.75.
After expanding the intervention throughout the hospital, 189 follow-up surveys showed that patient hand hygiene education increased from 48% to 53%, although overall opportunities for hand hygiene remained unchanged from 68%, and daily frequency of patient hand hygiene did not change significantly. Notably, CDI rates dropped significantly during the six months following hospital-wide implementation.
The investigators concluded that patient hand hygiene "should be considered a potential addition to CDI prevention measures in hospitalised patients." It's obvious really, isn't it? We've been so busy blaming the hospital staff and cleaners for the spread of HAI's, that we've lost sight of the fact that patients need to be kept clean too. Immobile patients really can't really keep themselves clean, and if staff so much as manually take a patient's pulse or plump up the pillows, they're likely to pick up germs, transferring them to multiple surfaces as they move about the hospital and on to the next patient...
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28th September 2017